Dentist fined for making fraudulent MediSave claims worth more than S$11,000

SINGAPORE: A dentist on Tuesday (Apr 19) admitted to making fraudulent MediSave claims worth S$11,250 while working at Phoenix Dental Surgery in Ang Mo Kio.

Dr Andy Joshua Warren, 36, was fined S$45,000 after pleading guilty to nine charges of cheating while he was a trainee dentist in 2015.

Another 15 charges were considered for sentencing, including charges for submitting six false Community Health Assist Scheme (CHAS) claims that amounted to about S$2,700.

Dr Warren is the second dentist to be dealt with in the claims fraud involving Phoenix Dental Surgery, which also had a branch in Marine Parade. Each clinic operated under a limited exempt private company, and both companies were struck off in 2018, according to court documents.

His supervisor, Teo Eu Gene, was sentenced to more than 10 months' jail in June 2020 and struck off the dental register in May 2021. Teo admitted to cheating polyclinics of more than S$18,000 in false CHAS claims.

Dr Warren currently runs his own dental practice and has been barred from making MediSave claims during the court proceedings, said his defence lawyer Riko Isaac.

The lawyer added that Dr Warren faces disciplinary action by the Singapore Dental Council.

SPLITTING UP CLAIMS

The court heard that Dr Warren received his Bachelor of Dental Science from the University of Melbourne in 2013. He practised as a trainee dentist in Australia and another dental clinic in Singapore before working at Phoenix Dental Surgery.

At the clinic, Dr Warren was primarily responsible for treating patients. He also gave instructions to clinic staff for administrative work such as patient registration and claims submission.

Central Provident Fund (CPF) members can use their MediSave funds to pay for day surgeries. Before Jan 1, 2014, the maximum claim amount for dental implant insertion was S$950, S$1,850 or S$2,600, depending on the complexity of the surgery.

From Jan 1, 2014, the maximum claim amount was revised upwards to S$950 multiplied by the number of dental implants placed, up to a maximum of S$7,550 for each surgery.

For each MediSave claim, the patient had to sign a MediSave authorisation form giving permission for the treatment expenses to be deducted, and the medical practitioner had to sign a letter of certification confirming that the procedure was performed.

To circumvent the pre-2014 MediSave claims limit, Dr Warren adopted a practice of splitting up the claims for the day surgeries that he performed into multiple days. This resulted in dishonest declarations of day surgeries on days when no surgery was actually performed on the patient.

Dr Warren continued to do this even after the higher MediSave claims limit came into effect in 2014, as he was not aware of the change.

For example, for one patient, Dr Warren submitted six MediSave claims for day surgeries purportedly performed on Jun 16, Jun 17, Jun 18, Jun 22, Jun 23 and Jun 24 in 2015.

In fact, he had only performed surgery on the patient on Jun 16 that year. The MediSave claims for the other five dates, amounting to S$6,250, were false.

Between June and September 2015, Dr Warren submitted a total of nine false MediSave claims of S$1,250 each for three patients.

He would first explain to the patient how much the procedure would cost and whether their MediSave account had sufficient balance to cover the entire cost.

After agreeing to the surgery, the patient would be asked to sign a number of MediSave authorisation forms. These corresponded to the number of claims required to cover the entire cost of the procedure.

Dr Warren would sign the corresponding number of letters of certification to confirm that the day surgeries were performed on the stated days.

Both sets of documents would then be handed to the clinic staff to make claims according to the letters of confirmation.

Dr Warren would also enter the details of the procedures into the patients' medical case notes, tailoring them to reflect the procedures and dates stated in the letters of certification.

On Apr 22, 2016, the Ministry of Health made a police report alleging that Dr Warren had cheated polyclinics into disbursing CHAS subsidies. Evidence of the MediSave fraud was uncovered in the course of police investigations into the CHAS fraud.

TARGETED A VITAL PUBLIC INSTITUTION: PROSECUTION

Deputy Public Prosecutors Sarah Thaker and Nicholas Lim asked for the fine that was eventually imposed, calling the offences "a serious case of fraud against a vital public institution".

Dr Warren's actions targeted the CPF Board, which is "the bedrock of Singapore's social security system" and the trustee of the hard-earned savings of Singaporeans, they said.

The fraud risked the erosion of public confidence in the CPF Board, so the offences needed to be dealt with strictly, said the prosecutors.

Trust was placed in Dr Warren as a medical professional but "he chose to abuse that trust and act in violation of his professional duties by participating in a fraudulent scheme to make dishonest claims", added the prosecutors.

They also argued that Dr Warren's actions were premeditated and that he had gone to lengths to cover up his actions by falsifying patients' case notes.

DID WHAT HIS SUPERVISOR SAID: DEFENCE

Mr Isaac argued that his client had no knowledge of the MediSave claims procedure at the time and relied on the instructions of his supervisor, Teo Eu Gene.

While Dr Warren was aware that he was deceiving the CPF Board about the dates on which the day surgeries were performed, he did so because this was what he was taught to do by his supervisor, said the defence lawyer.

Dr Warren's "moral culpability" was lower than in other cases where the fraud was done for a person's own financial gain, said Mr Isaac, who asked for a lower fine of S$27,000.

The lawyer also asked for leniency as his client was making significant financial losses due to not being able to make MediSave claims at his clinic, and also had to support his wife and young daughter, with another child on the way.

District Judge Christopher Goh said the fine sought by the prosecution was fair in light of the circumstances and already took into account Dr Warren's relative culpability.

Those found guilty of cheating can be jailed for up to three years, fined or both.